Symposium: Conscience, conditions, and access to civil society

SCOTUSblog

Richard Garnett*

It is striking how easy it has become for a person to stumble into the status of a symbol – or, these days, a viral meme. Jack Phillips is, or was until fairly recently, a skilled cake artist with a small business, Masterpiece Cakeshop, in suburban Denver. Today, he is a litigant in the Supreme Court of the United States and regarded by many as embodying the tension – increasingly, the conflict – between religious conscience and equality. . . Can he be required, though – should he be required, is it necessary for him to be required – to say something he thinks is not true, to disavow what he believes or to act expressively in violation of his conscience? . . . [Full text]

Appeal to sound medicine, not conscience rights: expert

Defenders of life called to polish arguments for the right to life

BC Catholic

Deborah Gyapong

U.S. physician and theologian is warning appeals to conscience rights may no longer be effective because they appear to pit physicians against their patients.

Instead, defenders of conscience rights must polish their rhetorical arguments in defence of good professional judgment and sound medicine, said Dr. Farr Curlin March 16. He was giving the annual Weston lecture sponsored by Augustine College.

A palliative care physician and co-director of the Theology, Medicine and Culture Initiative at Duke University in Raleigh, NC, Curlin has been called as an expert witness in the case of five Ontario doctors who are challenging the College of Physicians and Surgeons of Ontario’s policy that would force physicians to make effective referrals on abortion, euthanasia, and other procedures they may find morally objectionable.

“The policy is outrageous and unprecedented,” Curlin said. “It’s also incoherent.” . . . [Full text]

 

Pioneering Islamic scholar, defender of women coming to Fresno: ‘Islam, Christianity and Judaism share the same genome’

The Fresno Bee

Carmen George

An Islamic scholar who served as a consultant to the U.S. Department of Defense regarding Middle Eastern affairs and who helped draft Iraq’s constitution is this year’s Fresno Interfaith Scholar Weekend speaker.

“With what is going on in the world, we immediately decided it was an Islamic scholar that we needed – a great Islamic mind to share with us,” Jim Grant, chairman of the Fresno Interfaith Scholar Weekend Committee and director of the Social Justice Ministry for the Roman Catholic Diocese of Fresno, said about this year’s speaker, Abdulaziz Sachedina.

Sachedina is the International Institute of Islamic Thought chairman of Islamic Studies at George Mason University in Virginia. He will present a series of talks Friday through Feb. 26 at the Islamic Cultural Center of Fresno, Temple Beth Israel, Wesley United Methodist Church and Fresno City College centered around the theme, “Islam, Human Rights, and Interfaith Dialogue.” The annual event is sponsored by around 30 churches and organizations in the central San Joaquin Valley. . . [Full text]

Conscience and Conscientious Objection in Health Care

An ARC Discovery Project, running from 2015 to 2017

Summary of project

Conscientious objection is a central topic in bioethics and is becoming more ever important. This is hardly surprising if we consider the liberal trend in developments of policies about abortion and other bioethical issues worldwide. In recent decades the right to abortion has been granted by many countries, and increasingly many conservative and/or religious doctors are being asked to perform an activity that clashes with their deepest moral and/or religious values.

Debates about conscientious objection are set to become more intense given the increase in medical options which are becoming available or may well be available soon (e.g. embryonic stem cell therapies, genetic selection, human bio-enhancement, sex modification), and given the increasingly multicultural and multi-faith character of Australian society. Not only will doctors conscientiously object to abortion, and to practices commonly acknowledged as morally controversial, but some of them may also object to a wide range of new and even established practices that conflict with their personal values for example, Muslim doctors refusing to examine patients of the opposite sex.

Defining conscientious objection and identifying reliable markers for it, as well as setting the boundaries of legitimate conscientious objection through clear and justifiable principles, are difficult but pressing tasks.

This project advances bioethical debate by producing a philosophically and psychologically informed analysis of conscience, and by applying this to discussions about the legitimate limits to conscientious objection in health care.

 Personnel

Chief Investigator Dr Steve Clarke, Charles Sturt University

Chief Investigator Prof. Jeanette Kennett, Macquarie University

Partner Investigator Prof. Julian Savulescu, University of Oxford

[Full text]

‘Freedom of conscience’ a must, says doctor

Catholic Register

Michael Swan

TORONTO – It’s rare for an hour-long, academic lecture to get a standing ovation, but Dr. Ewan Goligher earned thunderous applause from about 100 people who turned up on a cold, rainy night to hear his defence of medical conscience.

The Toronto intensive care physician and researcher has become one of the leading voices opposing efforts to force doctors to make an “effective referral” for assisted suicide.

Goligher maintains that for the sake of medicine and democratic society, doctors must have a right to conscientious objection — not just for abortion but also for assisted killing.

“Freedom of conscience in the practice of medicine has been seriously eroded in recent years,” Goligher warned at the second annual deVeber Institute lecture delivered at the University of Toronto’s Wycliffe College on Oct. 27. . . [Full text]

Euthanasia Activists Have Taken Over Canadian Thought

Huffington Post

Will Johnston

The Canadian euthanasia issue marks a time of upheaval in medical ethics and the healthcare system which could be compared to events a century ago in Russia.

The Bolsheviks were not preordained to take over from the previous government, but their ruthlessness and aggression were unmatched. They demonized competing ideas and purged the social structures. They made their own laws. Nothing was allowed to stand. All was justified for public good, the good of the Proletariat.

The polite Canadian version seems to be that all control is justified by public funding. If a hospital accepts public money, a uniformity of euthanasia access is expected, a literally deadening uniformity.

People who would be ignored if they insisted that all welfare recipients be required to think alike, or that all Canada Council grants be used to create the same work of art, grab attention by bullying Catholic caregivers and hospitals which, like all hospitals, could not survive without tax dollars. . . [Full text]

Forum on Conscience Protections

United States Congress Energy and Commerce Committee

Friday, July 8, 2016 – 9:00am

Location: 2123 Rayburn House Office Building

PARTICIPANTS

Marie-Alberte Boursiquot – M.D., F.A.C.P., President-elect of the Catholic Medical Association
Prepared remarks

William J. “Bill” Cox – President of the Alliance of Catholic Health Care
Prepared remarks

Cathy DeCarlo – Nurse, New York
Prepared remarks

Richard Doerflinger – Former Associate Director of the Secretariat of Pro-Life Activities at the U.S. Conference of Catholic Bishops
Prepared remarks

Pastor Jim Garlow – Skyline Church, La Mesa, California
Prepared remarks

Donna J. Harrison, M.D. – Executive Director of the American Association of Pro-life Obstetricians and Gynecologists
Prepared remarks

Pastor Chris Lewis – Foothill Church, Glendora, California
Prepared remarks

Casey Mattox – Senior Counsel for the Alliance Defending Freedom
Prepared remarks

Fe Vinoya – Nurse, New Jersey
Prepared remarks

Dr. Dave Weldon – former Member of Congress and author of the Weldon Amendment, which was written to provide protections for entities that do not participate in abortion
Prepared remarks

 

 

 

Six questions about physician-assisted death, from a conscientious objector

National Post

Ewan C. Goligher

Canadian policy makers have recently proposed to require all doctors to provide an effective referral for physician-assisted death (PAD) upon the patient’s request. Forcing doctors to knowingly send their patient to another doctor willing to cause the patient’s death will seriously compromise the moral integrity of conscientiously objecting doctors and risks undermining the quality of patient care. To understand the position of conscientiously objecting doctors, consider the following questions.

1. Should doctors provide physician-assisted death merely because it is legal?

2. Must all doctors accept the assumptions underpinning the claim that physician-assisted death is good medical care?

3. If physician-assisted death remained illegal, would doctors be legally liable for making an effective referral?

4. Does the Charter right of Freedom of Conscience apply to doctors?

5. How does respect for conscientious objection affect patient care?

6. Will respect for conscientious objection obstruct access to physician-assisted death?

(For the author’s answers, see the full text)

Science, religion, public funding and force feeding in modern medicine

Responding to Bronca, T. “A conflict of conscience: What place do physicians’ religious beliefs have in modern medicine.” Canadian Health Care Network, 26 May, 2015.

Sean Murphy*

Tristan Bronca writes, “Belief without evidence is becoming incompatible with scientific sensibilities.”1

This notion might be exemplified by Dr. James Downar. Advocating for physician assisted suicide and euthanasia in Canadian Family Practice, he described himself as “a secular North American who supports individual autonomy, subject only to limitations that are justifiable on the basis of empirically provable facts.”2

Dr. Downar’s “Yes” was opposed by Dr. Edward St. Godard’s “No.”3 Since both are palliative care specialists, their differences on the acceptability of physician assisted suicide and euthanasia are not explained by differences in their clinical experience, but by their different moral or ethical beliefs.

However, neither Dr. Downar’s beliefs nor Dr. St. Godard’s can be justified “on the basis of empirically provable facts.” Nor can Dr. Downar’s support for individual autonomy, since empirical evidence demonstrates the primacy of human dependence and interdependence – not autonomy. Empirical evidence can provide raw material needed for adequate answers to moral or ethical questions, but it cannot answer them. As Dr. McCabe told Tristan Bronca, science is necessary – but not sufficient. Moral decision-making requires more than facts.

And the practice of medicine is an inescapably moral enterprise. Every time they provide a treatment, physicians implicitly concede its goodness; they would not otherwise offer it. This is usually unnoticed because physicians habitually conform to standards of medical practice without adverting to the beliefs underpinning them. Hence, the demand that physicians must not be allowed to act upon beliefs is unacceptable because it is impossible; one cannot act morally without reference to beliefs.

But Tristan Bronca asks specifically about whether or not religious beliefs belong in medical practice in a secular society. On this point, the Supreme Court of Canada is unanimous: “Yes.”

“Everyone has ‘belief’ or ‘faith’ in something, be it atheistic, agnostic or religious,” Mr. Justice Gonthier wrote in Chamberlain v. Surrey School District No. 36. “To construe the ‘secular’ as the realm of the ‘unbelief’ is therefore erroneous.”

“Why,” he asked, “should the religiously informed conscience be placed at a public disadvantage or disqualification? To do so would be to distort liberal principles in an illiberal fashion and would provide only a feeble notion of pluralism.”4

Thus, to argue that a “secular” society excludes religious belief perpetuates an error that contributes significantly to climate of anti-religious intolerance.

Guantanamo Restrain Chair Wikipedia Commons

Public funding of services is beneficial for patients, but quite distinct from physician obligations. After all, physicians provide many kinds of elective surgery and health services that are not publicly funded, and physicians are not paid for publicly funded services that they do not provide. Besides, our secular society taxes both religious and non-religious believers, so both have equal claims on “public dollars.”

Most important, public funding does not prove that a procedure is morally or ethically acceptable, any more than public funding proves that force-feeding prisoners in Guantanamo Bay is acceptable. Perhaps that point will come up in military proceedings against a navy nurse who refused orders to do so.5


The Canadian Healthcare Network posted this response in the on-line edition, which is accessible only to health care professionals and managers.


Notes

1.  Bronca, T. “A conflict of conscience: What place do physicians’ religious beliefs have in modern medicine.” Canadian Health Care Network, 26 May, 2015

2. Downar J. “Is physician-assisted death in anyone’s best interest? – Yes.” Canadian Family Physician, Vol. 61: April, 2015, p. 314-316 (Accessed 2015-06-04).

3. St. Godard E. “Is physician-assisted death in anyone’s best interest? – No.” Canadian Family Physician, Vol. 61: April, 2015, p. 316-318 (Accessed 2015-06-04).

4. Chamberlain v. Surrey School District No. 36 [2002] 4 S.C.R. 710 (SCC), para. 137 (Accessed 2014-08-03). “Madam Justice McLachlin, who wrote the decision of the majority, accepted the reasoning of Mr. Justice Gonthier on this point thus making his the reasoning of all nine judges in relation to the interpretation of ‘secular.’” Benson I.T., “Seeing Through the Secular Illusion” (July 29, 2013). NGTT Deel 54 Supplementum 4, 2013  (Accessed 2014-02-18).

5. Rosenberg C. “Top nursing group backs Navy nurse who wouldn’t force-feed at Guantánamo.” Miami Herald, 19 November, 2014 (Accessed 2015-06-04)

 

Your morality, my mortality: conscientious objection and the standard of care

Ben A. Rich

Abstract

Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards.


RICH, B. (2015). Your Morality, My Mortality: Conscientious Objection and the Standard of Care. Cambridge Quarterly of Healthcare Ethics, 24(2), 214-230. doi:10.1017/S0963180114000528